High-efficiency particulate arrest-filter vacuum cleaners increase personal cat allergen exposure in homes with cats.

Background: On the basis of experimental chamber studies, vacuum cleaners with double-thickness bags and integral high-efficiency particulate arrest (HEPA) air filters are claimed to reduce airborne allergen levels and are currently recommended to allergic patients.

Objectives: The objective of this study was to investigate the effect of vacuum cleaning on personal inhaled cat allergen exposure in homes with cats.

Methods: Five unused new vacuum cleaners were compared with an old non-HEPA filter vacuum cleaner.

The National Asthma Campaign Manchester Asthma and Allergy Study.

The NACManchester Asthma and Allergy Study is a prospective study of the development of asthma and allergies in childhood. The subjects (995 children at age 3 years) were recruited in utero by screening parents in the antenatal clinic using skin prick testing and a questionnaire regarding allergic diseases. Children were assigned to risk groups according to parental atopic status (high risk, both parents atopic; medium risk, one parent atopic; low risk, neither parent atopic).

Pharmacokinetics and systemic effects of inhaled fluticasone propionate in chronic obstructive pulmonary disease.

Aims: We have previously shown that the systemic exposure to inhaled fluticasone propionate (FP) is reduced in asthmatics compared with healthy subjects. We have now compared its pharmacokinetics in patients suffering from chronic obstructive pulmonary disease (COPD, n = 10) and matched healthy subjects (n = 13).

Methods: A double-blind, randomized, cross-over study design was used.

Effect of SCH55700, a humanized anti-human interleukin-5 antibody, in severe persistent asthma: a pilot study.

Antagonizing the effect of interleukin (IL)-5 is a potential new treatment strategy in allergic disorders. We evaluated the safety, biological activity, and pharmacokinetics of SCH55700, a humanized anti-human IL-5 antibody, in subjects with severe persistent asthma treated with oral or high doses of inhaled steroids. In a double-blind, randomized, multicenter trial, a rising single dose of SCH55700 (0.

Current mite, cat, and dog allergen exposure, pet ownership, and sensitization to inhalant allergens in adults.

Background: Simultaneous exposure to more than one allergen might modify the effect of individual allergens.

Objective: The purpose of this study was to investigate the effect of current exposures to mite, cat, and dog allergen and pet ownership on sensitization in adults.

Methods: Questionnaires, skin tests, and home visits (Der p 1, Fel d 1, and Can f 1, ELISA; mattresses, living room floors) were performed in 2502 adults.

Effects on lung function, symptoms, and bronchial hyperreactivity of low-dose inhaled beclomethasone dipropionate given with HFA-134a or CFC propellant.

The aim of this study was to compare the efficacy of BDP 200 microg bid via metered dose inhaler, using HFA-134a (Chiesi Farmaceutici S.p.A.

Skin test reactivity to natural and recombinant Blomia and Dermatophagoides spp. allergens among mite allergic patients in the UK.

Background: Many asthmatics in tropical and subtropical areas have positive skin prick tests to both Dermatophagoides spp. and to the mite Blomia tropicalis. This may be due to recognition by IgE of cross-reactive allergens between the different mite species or because of sensitization to species-specific allergens.

Childhood asthma.

Asthma is the most common chronic disease of childhood. Despite increasing evidence indicating that genetic and environmental factors have significant effects on airway development and function in early life, our understanding of the natural history of the disease is limited. The development of objective outcome measures will enable us to distinguish between children with transient early wheeze and those who will progress to persistent asthma, and to investigate factors affecting airway function throughout early childhood.

Clostridium difficile, atopy and wheeze during the first year of life.

Differences have been suggested to occur in the composition of intestinal microflora from allergic and non-allergic children. In this study we used a semi-quantitative enzyme-linked immunosorbent assay (ELISA) for the measurement of Clostridium difficile-specific immunoglobulin G (IgG) (CDIgG). CDIgG was excellent in differentiating between adults with or without Cl.

Seasonal variability in exercise test responses in Ghana.

Exercise-induced bronchospasm (EIB) is widely used in epidemiological studies to investigate the prevalence of asthma. We aimed to determine seasonal variations in the prevalence of EIB in Ghanaian school children from urban-rich (UR), urban-poor (UP), and rural (R) schools. We have previously reported the prevalence of EIB in 9-16-year-old children to be 3.

Tuberculin test measurement: variability due to the time of reading.

Study Objectives: It is recommended that the PPD Mantoux tuberculin test be read at 48 or 72 h. We have compared the measurements at these time points.

Design: A 10-tuberculin unit (TU) PPD Mantoux test was administered to 116 healthy subjects (76.

Household characteristics and mite allergen levels in Manchester,UK.

Background: Mite allergen levels vary enormously between different homes in the same geographical area. No large scale studies of mite levels in Manchester homes has been conducted to identify factors associated with higher levels.

Objectives: To quantify exposure to mite allergens and to identify characteristics associated with higher Der p 1 levels in a large sample of homes in Manchester, UK.

Fluticasone propionate via the Diskhaler or hydrofluoroalkane-134a metered-dose inhaler on methacholine-induced airway hyperresponsiveness.

Study Objective: s: To compare the effect of 4 weeks of treatment with fluticasone propionate (FP), 100 micro g bid, delivered either via the Diskhaler (GlaxoSmithKline; Middlesex, UK) or a hydrofluoroalkane (HFA)-134a pressurized metered-dose inhaler (pMDI) on airway responsiveness.

Design: A single-center, randomized, double-blind, double-dummy, placebo-controlled crossover study.

Setting: Outpatients.

Modulite technology: pharmacodynamic and pharmacokinetic implications.

In the drive to replace chlorofluorinated hydrocarbons (CFCs) by alternative more environmentally friendly propellants in pressurized metered dose inhalers (pMDIs), Chiesi has developed new inhalers using Modulite technology. The aim was to obtain CFC-free pMDIs which are equivalent, in terms of safety and efficacy, to the previous CFC devices at the same dose. When beclometasone dipropionate (BDP) and budesonide Modulite formulations were compared to the equivalent CFC products there was no significant difference in morning serum cortisol or urinary cortisol excretion, at the maximum recommended daily dose (2000 micrograms or 1600 micrograms respectively).

A qualitative exploration of treatment decision-making role preference in adult asthma patients.

Objectives: To explore preferred treatment decision-making roles, and rationales for role preference, and to identify perceived facilitators to and barriers from attaining preferred role.

Design: Qualitative design.

Setting And Participants: One secondary care and four primary care sites in North-west England.

An exploratory study of priority information needs in adult asthma patients.

The aim of this study was to gain insight into patients' perspectives on key information needs regarding their asthma. Focused conversation-style interviews were conducted with a purposive sample of 32 patients (aged 18-84 years; males=17, females=15) from five sites (four primary care, one secondary care) in North West England. Interviews were tape recorded and transcribed verbatim, then subjected to line-by-line content analysis.

Specific airway resistance in 3-year-old children: a prospective cohort study.

Background: The development of a method to assess lung function in young children may provide new insight into asthma development. Plethysmographic measurement of specific airway resistance (sR(aw)) is feasible in this age group. We aimed to identify risk factors associated with low lung function in early childhood in a prospective birth cohort.

Personal exposure to house dust mite allergen in bed: nasal air sampling and reservoir allergen levels.

Background: Assessment of personal exposure to dust mite allergen has relied on proxy measures. Only recently has a means to directly measure inhaled allergen particle number become available (the intra-nasal air sampler).

Objective: To quantify inspired dust mite group 1 and group 2 allergen-bearing particles in bed in undisturbed conditions prior to sleep by nasal air sampling and to investigate the relationship between inhaled particles and reservoir allergen levels.

A comparison of the efficacy and tolerability of single doses of HFA 134a albuterol and CFC albuterol in mild-to-moderate asthmatic patients.

Background: After the signing of the Montreal Protocol in 1987, new propellants for use in pressurized metered-dose inhalers that are non-ozone-depleting have been developed.

Objective: This study was designed to compare the efficacy and tolerability of single doses of albuterol/HFA 134a with albuterol/CFC and to demonstrate a dose-response among the different doses of both formulations.

Methods: A single-center, randomized, double-blind, placebo-controlled, cross-over study.

Controlling indoor allergens.

Objectives: Reading of this article reinforces the reader's knowledge of the role of allergen exposure in relation to asthma and its severity, as well as the relevance of allergen avoidance in the treatment of asthma.

Data Sources: Initial literature search for existing evidence-based guidelines, reviews, and meta-analyses was carried out, and further literature searches were performed to review individual randomized controlled trials. Evidence level was graded according to the Scottish Intercollegiate Guidelines Network recommendations.

Lung function at one month of age as a risk factor for infant respiratory symptoms in a high risk population.

Background: Abnormal premorbid lung function is a risk factor for subsequent wheezing in children with one or no atopic parent. This study was undertaken to establish whether early lung function in high risk infants (both parents atopic) was a risk factor for respiratory symptoms in infancy and to examine the influence of maternal asthma, smoking, and allergen exposure during pregnancy on any association.

Methods: Infants were recruited from the NAC Manchester Asthma and Allergy Study cohort at birth.

The role of indoor allergen exposure in the development of sensitization and asthma.

The role of indoor allergen exposure in the development of sensitization and asthma remains a subject of controversy. From a number of cross-sectional and longitudinal studies we can conclude that there is a very close association between allergen exposure and the sensitization of an individual. The dose-response relationships seem to differ between allergens; house dust mite and cockroach allergens appear to have a positive linear relationship, whereas cat allergens appear to act quite differently, with maximum sensitization developing at moderate exposure levels.

Exposure and sensitization in infants and children.

The complex relationship between allergen exposure, atopic sensitization and asthma in individuals and in populations has recently been a subject of controversy. A number of studies have demonstrated that allergen exposure in sensitized asthmatic individuals increases the severity of disease. A simple dose-response relationship between mite allergen exposure and specific sensitization in infants and children has been confirmed.

Valacyclovir prevention of cytomegalovirus reactivation after heart transplantation: a randomized trial.

Background: Cytomegalovirus (CMV) is a major cause of serious morbidity following solid organ transplantation via both direct and indirect mechanisms. The aim of this study was to investigate the efficacy and safety of valacyclovir prophylaxis in heart transplant recipients.

Methods: Twenty-seven CMV seropositive adults due to receive a heart transplant were included in a single-center, randomized, double-blind study.